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Pharmacology
Chapter 16 Blood-Modifying, Anti-neoplastic and Immunosuppressant Drugs
| Question | Answer |
|---|---|
| Explain the role of erythropoietin in RBC formation. | Erythropoietin is released by the kidneys when hypoxia is present. It stimulates bone marrow to form red blood cells. |
| Describe the significance of iron in hemoglobin. | Iron combines with oxygen when it is in the ferrous (Fe2+) state. Along with cobalt, copper, B vitamins, trace minerals & protein it is needed for normal hemoglobin & red blood cell formation. |
| What type of iron deficiency anemia occurs in veterinary medicine? | Baby pig anemia, which is caused by inadequate assimilation of iron from the placenta of the sow for future hemoglobin formation by the piglet. |
| List potential indications for hematinics and oxygen-carrying solutions. | Iron compounds prevent/treat baby pig anemia; erythropoietin treats anemia from renal failure in dogs/cats; androgens--treat anemia from renal failure; blood substitutes (oxyglobin)--dog anemia, not for patients w/ cardiac or renal disease. |
| Describe limitations of hematinics. | androgens--may cause hepatic toxicity; sodium & water retention. Blood substitutes--pulmonary edema; discolored urine & membranes; ventricular arrhythmia; volume overload; vasoconstriction. |
| Describe the clotting mechanism. | Can be initiated by intrinsic (intravascular) or extrinsic (extravascular) systems. Balance required between clot formation & clot breakdown. If any of the 13+ clotting factors are missing during clotting cascade, clotting doesn't happen. |
| List some anticoagulants. | heparin; ethylenediaminetetraacetic acid (EDTA); Coumarin derivatives; acid citrate dextrose (ACD) solution & citrate phosphate dextrose adenine (CPDA-1); anti-platelet drugs. |
| Discuss the method of action of heparin. | Prevents conversion of prothrombin (factor II) to thrombin, which prevents fibrinogen from converting to fibrin. Doesn't break down clots but can prevent them from increasing in size. |
| Describe the action of EDTA. | Prevents clotting by chelation of calcium (factor IV). Used in vitro to preserve blood samples; anticoagulant of choice for differential count. |
| Explain the action of coumarin derivatives. | Bind vitamin K, which inhibits the synthesis of prothrombin (factor II) and factors VII, IX and X. Used more in human med than veterinary. |
| Describe the action of ACD and CPDA-1. | Prevent clotting by chelating calcium; used in blood collection bottles. |
| Explain the method of action for anti-platelet drugs. | Appear to inhibit clotting by inhibiting platelet stickiness and clumping through inhibition of pro-aggregatory prostaglandin (thromboxane). Aspirin is an example. |
| List examples of topical hemostatics. | Silver nitrate sticks; hemostat powder; gelfoam absorbable gelatin sponge; Celox--granules made of chitosan (control bleeding in hypothermic conditions & heparinized blood); QuikClot Gauze Dressings--impregnated w/ kaolin & control along with compression. |
| Name the antagonist for heparin overdose. | Protamine sulfate--a protein produced from sperm or testes of salmon or related species. |
| List indications for use of vitamin K. | Natural vitamin K tied up or destroyed; bleeding disorders associated w/ poor formation of vitamin K clotting factors; rodenticide toxicity. |
| Describe potential side effects of vitamin K use. | anaphylactoid reactions; bleeding at injection site; IV administration contraindicated due to possibility of anaphylactoid reactions. |
| Define fibrinolysis and name a fibrinolytic agent. | Fibrinolysis is the breakdown or dissolution of thrombi (blood clots). Streptokinase, urokinase & alteplase are fibrinolytic agents. |
| Describe the phases of the cell cycle. | M1-mitosis; G1-active growth, RNA synthesis; G0-resting; S-DNA replication; G2-RNA synthesis, preparation for mitosis. |
| Describe alkylating agents. | Anti-neoplastic drug; cell-cycle nonspecific. Cross links DNA strands to change structure and inhibit replication. Ex. cyclophosphamide injections (cytoxan). |
| Describe the anti-neoplastic category of anthracyclines. | Derived from soil fungi, cell cycle nonspecific. Bind w/ DNA & interfere w/ RNA and protein synthesis. Ex. Doxorubicin most commonly used in veterinary medicine. |
| Explain anti-tubulin agents asanti- neoplastic drugs. | Plant alkaloids that are cell cycle specific for the M phase. They inhibit mitosis, causing cell death. Ex. vincristine, vinblastine (derived from periwinkle plant). |
| Describe how antimetabolites work as anti-neoplastic agents. | Cell cycle specific for S phase. Ex. methotexate (oral tablet or injection). |
| List miscellaneous anti-neoplastic drugs. | platiunum (carboplatin & cisplatin); asparaginase; glucocorticoids; piroxicam. |
| Define biologic response modifier (BRM). | Alters the relationship between tumor and host animal; improves host's ability to mount an anti-tumor response. |
| Describe monoclonal antibodies. | BRM; identical immunoglobulin molecules formed by a single clone of plasma cells. Produced by hybridoma; secrete large quantities of specific antibody. Direct cytotoxic effects on tumor cells. |
| Explain Interferon. | BRM; chemicals produced by leukocytes, fibroblasts & epithelial cells. Attempt to prevent the development of fatal disease in feline leukemia virus (FeLV) infected cats; extend survival time of cats w/ feline infectious peritonitis (FIP). |
| List indications for the use of immunosuppressive drugs. | Overactive, improperly responding immune system; lymphocytic-plasmacytic enteritis; rheumatoid arthritis; immune-mediated skin disease; hemolytic anemia. |
| Give five examples of immunosuppressive drugs. | azathioprine-affects S phase; cyclosporine-inhibits proliferation of T lymphocytes; metronidazole-w/ corticosteroids to enhance; cyclophosphamide-alkylating agent; corticosteroids-inhibit neutrophils, T lymphocyts, blood vessels, cell messengers |
| Discuss safety precautions for use of anti-neoplastic drugs. | minimize risk of topical contamination; use safety goggles; no food/drink in chemo area; separate chemo waste from other sharps/biochemicals; PPE when cleaning 48 hours after admin (caution clients too) |
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kidtaxi9
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